Who's Who In The Hospital

A patient arrives in the emergency room at 9 p.m. with chest pain. She is having a heart attack. At 10 p.m., she is admitted to the hospital and is sent for emergency angioplasty. At 11 p.m., she is sent to the Cardiac Intensive Care Unit for monitoring. When her private doctor sees her at 7:45 a.m., she has already talked to numerous doctors and nurses.

Being hospitalized can be confusing and frightening. The definitions below will help you understand the roles of the doctors and nurses you meet.

What is a nurse?

Hospitals can't run without nurses. They are often the first to see patients and work in the same specialties as doctors. Their skills range from drawing blood for lab tests to performing advanced cardiac monitoring.

In the earlier example, at least three nurses were involved, including two specializing in cardiology. The triage nurse was first to see the patient, deciding how severe the patient's symptoms were by asking some questions and doing a brief examination. At least one nurse helped the cardiologist with the angioplasty and one or more nurses worked in the Cardiac Care Unit to meet the patient and care for her after the procedure.

What is the difference between an intern and a resident?

After graduating from medical school, doctors must complete a training program. This is called a "residency." During the first year of residency, a doctor is called an "intern." After the first year, interns become "residents." Both interns and residents are members of the hospital house staff. They are employed by the teaching hospital and are supervised by a hospital staff doctor.

What is an "attending" doctor?

Also called a hospital doctor or "staff" doctor, an attending physician is the doctor in charge of the patient's care. The attending is a senior doctor in general medicine or in a medical or surgical area. An attending in a teaching hospital supervises interns and residents.

Primary care doctors see patients in the office setting and on "rounds" (see next paragraph) in the hospital. At least four attending doctors were involved in the patient's care in the earlier example: one emergency room doctor, two cardiologists and the patient's primary care doctor.

What are "hospital rounds?"

"Rounds" are the examinations of patients in the hospital. Both doctors and nurses make rounds.

Why do I need to keep answering the same questions?

Each doctor or nurse involved in your care needs to know about your medical history. For this reason, you may be asked similar questions repeatedly. Below are some tips to make answering them easier.

Tips for dealing with repeated questions:

• Carry medical records that list your conditions. Also have lists of your current medications and allergies. A printed summary of your medical history written by your doctor can be very helpful.
• Wear a medical alert bracelet if you have certain conditions, like diabetes, drug allergies, life-threatening food allergies, or asthma.
• Carry contact information for all of your doctors.

Source:

Kupersmith J. M.D., "Quality of Care in Teaching Hospitals." Association of American Medical Colleges. 2003

This article was reviewed and updated June 2007.